Gestalt therapy

Intro

As I really like comparison of psychotherapy and traveling, at the initial therapeutic session I take it to explain to my clients what they can expect from therapy.
So, the client is a traveler having arrived from somewhere, thus bringing some luggage, maps and experiences during their past life journey. Sometimes they know exactly where they want to arrive, sometimes they have no clear idea where to go, whereas sometimes they are lost, just wandering in circles.

Therapist takes over the role of a travel mate. It is not therapist’s journey but therapist takes part in it. At the beginning, therapist helps the client determine direction and goal of the journey, therapist walks with the client at their pace, helps them carry the luggage, asks them questions, reminds them where they are heading to when the client forgets it, and encourages them when they get tired. It is all right that therapists tell the client how they feel on the journey, pointing to various tracks, by-paths, and ways of traveling, but it is not all right to make choices for the client. Decision on where and how is on the client.

They may find themselves at a long abandoned place. Clients can hardly recollect that they were there long time before, feeling a thrill about the place, want to get away because it feels too painful to stay. The role of therapist is to help the client endure with all their emotions that occur and to give them a new meaning when they can, then just move forward.

Sometimes the client and therapist will simply sit together on the bench, breathing and recuperating, occasionally exploring and rejoicing together.
Each journey is different, and each traveler is different. As a therapist, I never know where it will take me. I only know that I like traveling and am grateful to my clients for their trust allowing me to be their traveling mate.

Gestalt psychotherapy

There are numerous psychotherapeutic lines, but all of them have the goal in common, briefly, help the client improve their mental health, increase their joy of life and energy, and function better in their daily life.
Although the goal is the same, the paths to reach it may vary depending on the type of psychotherapy; some psychotherapy modes may prove more successful when dealing with particular issues and topics.

Gestalt therapy is applicable in almost all life situations, as well as when dealing with all sorts of issues and challenges, individually or in groups.

The German word Gestalt means an organized whole that is perceived as more than the sum of its parts. At first it may seem unclear but it is just how we perceive man in Gestalt therapy, i.e., in a holistic way, as a whole being in all their bodily and mental aspects, just now and in their current living context.

Therapy is focused on what is happening 'here and now', in the immediate context between the client and therapist. In Gestalt therapy, therapist does not approach the client as 'a scholarly professional’ who knows everything about the client but assumes the 'me-you' equal footing relationship with the client. In Gestalt therapy, we do believe that the client is fully capable and competent to live their own life, while the therapist's role is to help, direct and support him/her in achieving this goal. This therapy enables the client to experience a relationship in which he/she/they is accepted just as he/she/they is, without any sort of assessment or judging but being supported and having an opportunity to know and accept himself/herself, their differences and uniqueness.

In Gestalt therapy, therapist himself/herself and contact with the client is the main working tool. During our work with the client, we carefully observe this contact, whether relationship can be established and how to do it, how it is changes over time, and how the client perceives it at the specific moment. Through therapeutic contact, therapist will stimulate the client to experimenting and exploring. In order to make the client experience various dimensions of their perception, in addition to conversation many creative techniques such as sketch, motion, playing roles, work with the body and movement, associative cards, figurines, etc., are used in therapy.

Even when talking about past events or traumas, we focus on how the client feels right now while talking to therapist, i.e., our focus is on ‘here and now’.

The goal of Gestalt therapy is to make the client, through contact with therapist, aware of their real needs and to be able to differentiate them from the ‘musts’ and ‘shoulds’ by the environment. Through raising their awareness of the self, the client learns how to recognize their own patterns in daily living and thinking. We generally do not reconsider our thinking, feelings and behaviors in particular situations. They just happen and we accept them because ‘it has always been so’, ‘it is correct’, ‘we do it so in my family’, and we repeat them over and over, frequently suffering. Some patterns we have acquired long before from those who took care of us (parents) helped us live more easily then, and occasionally just survive within our own family. When we grow up, our environment has changed, we live surrounded by some other people, in a world where some other rules are followed, and suddenly the old patterns are not valid and functional anymore, or may even be harmful. When we become aware of it, we can change them and choose willingly to act differently in the next situation. Awareness is one of the key concepts in Gestalt therapy because it is only the individual aware of their own needs, thoughts and emotions that is really able to make choice and take responsibility for their decisions and behavior, and thus full freedom of living at their own measure.

Who is Gestalt therapy intended for?

The answer to this question is very simple – everyone! To be more precise, for all those feeling the need and wish to know himself/herself at a deeper level and to improve one’s own mental health.

The World Health Organization defines mental health as a “state of well-being in which the individual realizes his or her own abilities, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to his or her community” (WHO, 2001). In layman's terms, mental health is our capacity to cope with problems and challenges in various life situations and areas. These may be interpersonal and romantic relationships, loss of a close person, mourning, work, school or university, parenting, health, financial issues, various sudden and/or uneasy situations, etc.

Problems in one (or more) life areas may be less pronounced and the individual may perceive them as something distracting but he/she/they still can function well. Occasionally, however, prolonged coping with the unpleasant situation or due to some trauma or stress may result in more serious disturbances, problems, and clinical picture (diagnosis).

Clients usually present when symptoms have persisted for some time. For example, they are coping with long-standing anxiety, suddent panic attacks, long-term apathy and listlessness, anger and aggressiveness beyond their control, psychosomatic disorders, insomnia and repeated unpleasant thoughts, low self-esteem, worthlessness, and poor interpersonal relationships.

It is recommended to present for therapy before the problem starts compromising the individual's quality of life and functioning but clients usually present only when coming to the end of one's tether and cannot cope with the problem by themselves. Occasionally they are stimulated to present for therapy upon some sudden stressful or traumatic event, however, quite frequently there are a series of minor events summed up over time.

I am very glad to realize that recently, ever more individuals recognize the usefulness of working on oneself and perceive psychotherapy as an opportunity for personal growth and development. Curiosity about oneself is excellent motivation to enter the psychotherapeutic adventure.

What are 'good' topics for psychotherapy?

Is my issue a 'good' topic for psychotherapy? Is my problem serious enough (because other people have more severe problems)? – these questions are quite frequently put by new clients, at the same time being the reason for postponing their presenting for psychotherapy.

There is a great variety of topics in psychotherapy, however, it should be emphasized that everyone 'has the right' to their own problems and help in solving them. If you estimate that your neighbor or friend is burdened with 'more serious' problems compared to yourself, it is the same as if you say that you will not eat because someone else certainly suffers more severe hunger. It will not help that other person, and it definitely will not help you.

Here are some of the most common issues due to which clients present for therapy: anxiety, depression, loss and mourning, crises, traumatic experience, acute or chronic stress, burnout at workplace, interpersonal and romantic relationships, setting boundaries, career challenges, occupational choices, getting to know oneself, personal growth and development, etc.

What is the (first) psychotherapeutic session like?

Psychotherapeutic relationship, just like any other relationship, begins by getting to know each other.
At the initial meeting, the client talks to me about their motivation and reason for therapy, while I ask additional questions in order to achieve better mutual understanding and knowing each other. Then I explain to the client what Gestalt therapy is, we define the rules of work, discuss what we expect from therapy, and set therapeutic goal.

I tell the client some basic information about myself. It is very important for the client to perceive therapist as a trustful person they can and want to work with.
Clients frequently believe that they have to expose and tell everything about themselves at the first session, although feeling quite uncomfortable about it. However, this belief is wrong; on the contrary, clients should tell the therapist as much as they feel good, in other words, the client should 'take care of their boundaries', as we say in therapy, thus it is normal not to tell everything at the initial session. Our mutual relationship is built gradually, along with increasing mutual confidence and readiness to share.